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Cataract Treatment & Surgery

What is a Cataract?

A cataract is when the natural lens within your eye becomes cloudy affecting the way light enters the eye, in turn blurring your vision. Symptoms of cataract can vary but include:

  • Reduced vision
  • Changes to your glasses prescription
  • Glare
  • Altered depth perception
  • Colours becoming faded

What Causes Cataracts?

Cataracts are very much part of the normal ageing process but can develop earlier in some cases. Causes can include:

  • Diabetes
  • Longer term use of steroid medications
  • Previous eye surgery or trauma
  • A family history of cataracts
  • Eye conditions such as Uveitis

The exact cause of cataracts is not fully understood but other factors that are believed to also cause them, including ultraviolet light exposure, smoking, excessive alcohol consumption and poor diet.

 

Find out more from Dr Andrew Tatham in this short video

What treatment/surgery options are available?

Along with removing the cloudy lens, cataract surgery is likely to be a great opportunity to correct or reduce any prescriptions of short sight, long sight and/or astigmatism. Your Surgeon will discuss the options that are available to you, allowing you to choose the best fit for your lifestyle. Intraocular Lenses (IOLs) can be used in place of the cloudy cataract lens during surgery. The lenses aim to give you sharp vision, assuming your eyes are in otherwise good health.

Regardless of which IOL you choose the surgery itself is almost identical but the lens technologies can vary significantly.

Monofocal IOLs

These lenses aim to give sharp vision at a single distance. For example if the lens is chosen to give clear distance vision then you would need reading glasses. These lenses do not correct astigmatism.

In some cases each eye can be set at a different focus known as mono vision or blended vision. To ensure you can tolerate this your surgeon may request that your optometrist trials this outcome by prescribing contact lenses that will mimic the result.

Aspheric IOLs

These lenses can be either mono or multifocal and are designed to give the optimal visual result and may also improve vision in lower contrast conditions.

Multifocal / Extended Range IOLs

If you want a greater degree of freedom from wearing glasses these lenses may be an option. They work in a similar way to multifocal contact lenses and aim to give useful vision for both distance and near. If you have other eye problems these lenses may not be suitable, this will all be explained at your appointment.

TORIC IOLs

If you suffer from astigmatism then a TORIC IOL may be offered to correct / reduce this. In most cases Astigmatism is when the clear window at the front of your eye (the cornea) is shaped more like half a rugby ball rather than half a football. The aim of these lenses is to reduce the astigmatism enough to be less reliant of glasses. A special shaped lens implant is positioned at a certain angle to counter balance the astigmatism in your Cornea. Standard Monofocal and Multifocal IOLs do not correct astigmatism, however TORIC IOLs can come in both mono and multifocal.

When should you have Cataract Surgery?

It is commonly advised to consider cataract surgery when your symptoms start to affect your daily activities, to include:

  • Driving
  • Work
  • Hobbies
  • Personal safety

Cataracts continue to develop with time so your vision will get worse if left untreated.

How do you treat Cataracts?

Regarding treating Cataracts, surgery is the only option. Once you have significant symptoms the cloudy lens material is removed and a lens implant is inserted in its place. Phacoemulsification is by far the most common technique to do this. This type of surgery is carried out as a day procedure normally under Local Anaesthesia but you can request some sedation or even a general anaesthetic if required.

Once your eye is anaesthetised (numb /frozen) the surgeon will make a very small incision in the cornea (the clear window at the front of the eye). A small probe is inserted through the small incision and emits ultrasound waves to break up the cloudy lens. The lens material is turned to liquid and is gently sucked out through a tube. Once finished the surgeon will inject in a folded up lens implant which will position itself nicely where the old lens once was. In most cases no stitches are required and the wounds heal by themselves.

Are there any side effects?

You will be able to go home the same day, with the whole appointment being around 3 hours

Depending on the type of anaesthetic used the feeling should return in a few hours of the surgery but it can take days for the vision to start to improve. On discharge your nurse will go through signs and symptoms of potential problems and how to seek help, however it is quite normal to experience:

  • Watering
  • Blurred or double vision
  • Gritty or a foreign body sensation
  • Bloodshot or red eye

These symptoms normally improve within a few days but can take several weeks to fully recover.

What can affect your result?

Although a very straight forward and safe procedure there are some small risks of potential complications. These can vary between patients and will explained in detail at your appointment, allowing you to weigh up the pros and cons of surgery before making a decision. Some factors which could affect your result include:

  • The presence of other eye conditions
  • The accuracy of the measurements taken to choose the IOL power (Biometry)
  • The type of IOL used
  • The healing process / inflammation

What happens after surgery?

Your nurse will go through a thorough discharge pack with you before you go home. Emergency phone numbers will be issued just in case you have any problems afterwards and your nurse will explain what symptoms to look out for and when to seek help.

You will go home wearing an eye shield/ pad which you leave on until the morning. Your nurse will explain how to remove and bathe your eye the next morning. It may be advised to replace the shield at bedtime for the first week. Drops will be required for around 4 weeks after the surgery to prevent infection and inflammation. You will be advised to avoid strenuous activity and swimming pools for several weeks after the surgery. You will be advised regarding driving after surgery, this can vary between patients. Essentially you can drive as soon as you can meet the visual standards for driving as set by the DVLA.

How soon you can return to work will depend on your type of job and whether or not you need new glasses. Your surgeon will be able to advise you regarding this.